We speak of “sciatic” pain when the sciatic nerve or its nerve roots are compressed. Where is it in the body? How do sciatic nerve pain manifest itself? What are their causes? Answers with physiotherapist Leo Simon.
Definition: What is the sciatic nerve?
The nerve sciatica East the thickest and longest nerves of the human body. “This peripheral nerve is both sensitive (i.e., it conducts pain, temperature, etc. signals) and engine (that is, it is responsible for muscle contraction, whether voluntary or not)“, develops Léo Simon, physiotherapist.”Consisting of nerve fibers of several roots arising in the spinal cord, it innervates the motor skills of the vast majority of muscles of the lower limb“He continued.
What is the path of the sciatic nerve?
The sciatic nerve originates in the spinal cord at the nerve roots L4 to S3 (from the fourth lumbar vertebra to the third sacral vertebra) and passes through the inside of the pelvis and buttocks, between the muscles piriforme and twin. “From the exit of the pelvis, it descends to the level of the femur, in the middle of the thigh or behind the knee, depending on the person.“, adds Léo Simon. He gives everything posterior innervation of the thigh of the leg and foot. Below the knee, the sciatic nerve separates into two new nerve connections: the tibial nerve and the common fibula. Often one Pain in the sciatic nerve is associated with back pain. We then talk about lumbosciatica.
Sciatica nerve pain: what causes it?
“Pain can be felt when the sciatic nerve is compressed or stretched“, says the physiotherapist. This is one sciatic nerve neuralgia. Usually one hernia discale is the cause of this pain. This condition is caused by a migration of the nucleus to the heart of the intervertebral disctowards the spinal canal. The hernia can cause compression of one of the roots of the sciatic nerve. However, a herniated disc does not always cause pain in the sciatic nerve. In rarer cases, dthe ‘lumbar osteoarthritis or trauma may also come to explain this symptom. Even rarer, one tumor may be causing this type of pain. Finally, the cruralgia, which refers to inflammation of the femoral nerve, causes pain similar to sciatica in the lower limb. But they are not located in exactly the same place, since other nerve roots are affected.
These pains can be felt on the side and back of the leg. You may also have pain that follows a line in the leg that goes all the way to the foot. “The patient suffers from neuropathic pain and feels like electric shockstingling or muscle weakness in the leg and foot“describes Leo Simon. Other patients say they have one painful sensation of cold or like razor blades. But the leg shows no signs of swelling or redness. According to the nerve root affected, the location of the pain varies. “If the L5 root is affected, the pain is located behind the thigh on the outside of the knee, on the outside of the leg, the top of the foot and the big toe.“, says Health Insurance on its website. When the S1 root is reached, “sciatica pain is located behind the thigh, behind the knee, at the calf, heel, sole and outer edge of the foot up to the last three toes“, adds the body. “Attention, other pathologies such as ankylosing spondylitis cause the same type of symptoms and sciatic nerve pain can be confusedwarns Leo Simon.
What tests should be done for sciatic nerve pain?
The doctor performs a clinical examination including different types of provocation test of pain. Based on this clinical examination, it may or may not give the patient additional examinations to be performed as one MRI or scanner.
The prescription of physiotherapy is not systematic and at the discretion of the physician. If it is a herniated disc, it resolves on its own most of the time. “When the pain subsides, patients are advised to walk if they can, and to regain gentle mobility by making sure they breathe properly.he explains. Some stretching and exercises and flexibility can also help relieve sciatica. Finally, when there is a ponytail syndrome, for example, and paralyzing sciatica or any other sign of severity, herniated disc surgery is required.
Thanks to Léo Simon, physiotherapist in Paris.